344x Filetype PPTX File size 0.11 MB Source: nahu.org
Marketing Requirements and Other
Regulations
HIPAA Privacy
HIPAA stands for: Health Insurance Portability and Accountability Act
Agents have responsibilities for ensuring the privacy of clients’ Protected Health Information
(PHI) including, but not limited to:
Health Information
Claims Information
Social Security Numbers
Banking Information
This information can only be used for the purpose in which it is collected.
https://agentsurvivalguide.com/what-are-agents-responsible-for-under-hipaa
Marketing Requirements and Other
Regulations
Health and Human Services as well as other government entities along with
plan sponsors are allowed to modify existing and establish new guidelines for
how agents must handle PHI and can audit agents and agencies.
As technology evolves the policies put into place are becoming more and more
complex such as a new technology law passed in New York.
Here are some guidelines for HIPAA compliance and protecting client
information.
https://agentsurvivalguide.com/what-are-agents-responsible-for-under-hipaa
Sales Events
Anytime an agent conducts sales or marketing activities with a prospect or
client regarding Medicare Advantage or Part D it is considered a Sales Event
There are two types:
Formal
Informal
These events must be filed with CMS through a Plan Sponsor at least 7 days
prior to the event or 7 days prior to when it will be advertised. Any changes
to the event must be updated with the plan sponsor.
Whether on the phone or in person, there are many rules that must be
followed.
Permission to Contact (PTC)
Another pre-sale activity that often causes confusion for agents is
Permission to Contact.
Permission to contact can be particularly confusing for tele sales agents who
often confuse it with the Scope of Appointment (SOA), seeing both items as
synonymous with one another which is not the case.
Permission to contact should always be collected and documented prior to
obtaining a SOA.
Even if a client is an unsolicited walk in or call in, the agent should
document it to protect himself/herself in case of an audit or complaint.
Check Point Question
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